The impact of specific comorbidities and overall multimorbidity on the three mechanistically distinct phases of COVID-19 NatureMedicine EdinburghUni COVID19 coronavirus covid comorbidity SARSCoV2
By Neha MathurFeb 21 2023Reviewed by Danielle Ellis, B.Sc. In a recent study published in Nature Medicine, researchers studied the impact of comorbidities, i.e., the presence of pre-existing diseases, in the three distinct phases of coronavirus disease 2019 - severe acute respiratory syndrome coronavirus 2 replication phase, inflammatory lung injury, and post-acute sequelae of COVID-19 . In addition, they examined the effect of multimorbidity, i.e.
Establishing a causal relationship between comorbidities and COVID-19 outcomes besides confounding factors Many large-scale observational studies have explored the biological mechanisms through which comorbidities make individuals prone to progress to severe COVID-19. However, distorted associations can arise due to study design, sampling, and results interpretations. Similarly, one's comorbidity status could determine the likelihood of SARS-CoV-2 exposure.
Impact of comorbidities during three COVID-19 phases - acute viral illness, inflammatory lung injury & PASC Genetics & Genomics eBook Compilation of the top interviews, articles, and news in the last year. Download a free copy The RECOVERY trial evaluating dexamethasone provided the most remarkable evidence of mechanistic differences between the acute illness and the inflammatory lung injury phases, two of the three COVID-19 phases discussed in this study.
However, now data has accrued on how specific comorbidities result in the development of PASC. A recent study found that the incidence of PASC varied between 2.8% and 5.5% vs. 1.8% in people with and without comorbidities. Furthermore, studies have described a suite of specific new onset symptoms following acute COVID-19, defined as non-hospitalized and hospitalized cases and those requiring ICU.
Most intriguingly, multimorbidity could increase the risk through clinical interventions, which might reduce the likelihood of survival and impair the survivor's quality of life. Together, these findings necessitated that the clinical guidelines for COVID-19 management are customized per individual circumstances, especially when considering invasive treatments.
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Higher anxiety and perceived trauma among COVID-19 patients: a prospective comparative study - BMC PsychiatryBackground and purpose Psychiatric disorders such as anxiety, depression, and traumatic stress are not rare during infectious outbreaks, as the COVID-19 pandemic has posed a great concern to the general population. In this study, we aimed to investigate whether experiencing psychiatric symptoms during COVID-19 is the result of the burden of carrying an illness or the COVID-19 itself. Method Two hundred ten subjects and three different groups of participants (COVID-19 patients, university staff, and orthopedic patients) were recruited. They answered a demographic questionnaire, Yale-Brown Obsessive–Compulsive Scale (YBOCS) test for OCD symptoms, Impact of Event Scale-Revised (IES-R) for perceived trauma, Beck Anxiety Inventory (BAI) for anxiety, and Beck Depression Inventory (BDI) for depression assessments using phone or face-to-face interviews. Result At least one OCD symptom was observed in 85.7% of the subjects. However, there was no significant difference between the 3 groups (p = 0.2194). Perceived trauma was significantly higher among COVID-19 patients followed by university staff and orthopedic patients (23.73, 16.21, 11.51 mean IES-R scores respectively, p = 8.449e−14). COVID-19 patients also showed higher anxiety (mean BAI score: 17.00) than the university staff and orthopedic patients’ group (9.22 and 5.56 respectively) (p = 6.175e−08). BDI score did not show much variation for depression, the mean score was 9.66, 9.49, and 6.7 for the COVID-19 patients, university staff, and orthopedic patients respectively, (p = 0.2735). Conclusion Perceived trauma and anxiety symptoms are significantly higher in COVID-19 patients and the symptoms of OCD and depression do not differ between COVID-19 and non-COVID-19 people, so the necessity of screening and following treatment of patients with COVID-19 should be kept in mind. Trial registration IR.IUMS.FMD.REC.1399.761.
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